AMERICAN ASSOCIATION of PHYSICISTS IN MEDICINE
AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
AAPM NEWSLETTER Advancing the Science, Education and Professional Practice of Medical Physics
“Participating in AAPM has been one of the most valuable and rewarding aspects of my career — indeed of my life...” John Boone AAPM President
IN THIS ISSUE:
Emerging Role for HIFU Comes into Focus
▶ International Affairs
Subcommittee Report ▶ TG-51 Working Group Update
▶ AAPM History Committee
Report ▶ Insurance Subcommitte Report
and more...
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▶ Research Spotlight:
NEW AND EXCITING FEATURES THIS YEAR… • President’s Symposium: Revitalizing Scientific Excellence: Turning Research into Clinical Reality through Translational Research. NEW! Special 3-Day Program on Ultrasound • This track highlights recent advances in ultrasound for diagnostic imaging, ultrasound for guidance and control of radiation therapy, and therapeutic ultrasound such as MR guided HIFU. Each daily track begins with an Educational Session related to the subsequent scientific sessions: a hands on ultrasound workshop to highlight US imaging and therapy systems; a primer on Image-guided High-Intensity Ultrasound (HIFU) therapies; and a primer on QA for diagnostic ultrasound. • Carson-Zagzebski Distinguished Lectureship on Medical Ultrasound: Dr. Mickael Tanter, PhD, from the Institut Langevin, École Supérieure de Physiqueet de Chimie Industrielles de la Ville de Paris, will provide an overview regarding ultrafast ultrasound imagingcurrent applications and changes to the future paradigm of diagnostic imaging and therapeutic monitoring. NEW! Certificate of Completion Program in Magnetic Resonance Guided Radiation Therapy – The Certificate of Completion Program is a new offering from AAPM which provides an in-depth review of a particular topic with verification of learning achieved through an on-line examination. Sessions are available to all meeting registrants, but those who enroll in the program for an additional fee are entitled to dedicated seating in the mini-track sessions as well as additional online materials. Following the meeting, certificate program participants will be required to take an on-
line examination, which covers the material presented throughout the day-long mini-track. Enrollees who demonstrate satisfactory attendance at the course and successful completion of the on-line examination (available after the meeting) will receive a framed certificate of completion for this course. NEW! Coordinated Educational/Scientific Sessions Invited sessions which provide both educational and scientific content from leaders in the field. Come to the first session to learn all the background information; stay for the second session to see the latest scientific developments on that same topic. Topics for coordinated sessions include knowledge-based automatic treatment planning, quality assurance and safety research, and CT lung cancer screening. NEW! Electronic Poster Theater • Reinvigorating scientific presentations through electronic poster sessions lead by a Campus Provost, Monday and Tuesday afternoons in the exhibit hall. • Best in Physics – the top 5 abstracts in each track, Imaging, Joint – Imaging and Therapy, and Therapy, will be highlighted on Sunday afternoon in an electronic poster theater in the exhibit hall.
• In addition to Symposia and regular Sessions, Keynote Sessions on topics of special interest.
• Joint scientific symposium with the World Molecular Imaging Society – Linking Pre-Clinical and Clinical Trials: Co-Clinical Trials.
• Joint scientific symposium with ESTRO – Imaging Markers for Assessment of Treatment Response.
ARTICLES IN THIS ISSUE 5 7 11 13 15 17 20 23 31 33 35 37 39 43 46
President’s Report Executive Director’s Column Editor’s Column Education Council Report Professional Council Report Science Council Report ABR News Legislative & Regulatory Affairs Report ACR Accreditation FAQs International Affairs Subcommittee Report AAPM History Committee Report TG-51 Working Group Update Research Spotlight Insurance Subcommittee Report AAPM HQ Team... At Your Service!
EVENTS/ANNOUNCEMENTS 2 4 11 14 16 22 26 32 36 41 42
AAPM 2015 President’s Symposium MRgRT Certificate of Completion Course New Member Benefit: ICRU Publications AAPM 2015 App SRT/SBRT: Safe and Accurate Delivery of Hypofractionated Radiation Therapy eRA Commons ID AAPM 57th Annual Meeting & Exhibition AAPM Expanding Horizons Travel Grant AAPM New Member Symposium AAPM Career Services Focus on Our Future
AAPM NEWSLETTER AAPM NEWSLETTER is published by the American Association of Physicists in Medicine on a bi-monthly schedule. AAPM is located at One Physics Ellipse, College Park, MD 20740-3846
EDITORIAL BOARD Editor Mahadevappa Mahesh, MS, PhD Johns Hopkins University E-mail: mmahesh@jhmi.edu Phone: 410-955-5115 John M. Boone, PhD Robert Jeraj, PhD George C. Kagadis, PhD E. Ishmael Parsai, PhD Charles R. Wilson, PhD SUBMISSION INFORMATION Please send submissions (with pictures when possible) to: E-mail: nvazquez@aapm.org AAPM Headquarters Attn: Nancy Vazquez One Physics Ellipse College Park, MD 20740 Phone: (301) 209-3390
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PUBLISHING SCHEDULE The AAPM Newsletter is produced bi-monthly. Next issue: September/October Submission Deadline: August 12, 2015 Posted Online: Week of September 1, 2015
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EDITOR’S NOTE I welcome all readers to send me any suggestions or comments on any of the articles or new features to make this a more effective and engaging publication and to enhance the overall readership experience. Thank you.
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CONTENTS
AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
PRESIDENT’S SYMPOSIUM Revitalizing Scientific Excellence: Turning Research Into Clinical Reality Through Translational Research Monday, July 13 • 10:15 AM – 12:15 PM • Ballroom B
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he overall goal of this symposium is to illustrate the bidirectional exchange between medical research and clinical practice. Revitalizing scientific excellence in clinical medical physics challenges practitioners to identify clinical limitations, which then drive research innovation; research funded by the NIH and other agencies develops technological solutions to these limitations, which are translated to the care environment to ultimately improve clinical practice in radiology and radiation oncology.
PRESENTERS Roderic I. Pettigrew, PhD, MD Director, National Institute of Biomedical Imaging and Bioengineering (NIBIB), NIH The role of the NIH in funding innovations in science and medicine Prior to his appointment at the NIH, Dr. Pettigrew was Professor of Radiology, Medicine (Cardiology) at Emory University and Bioengineering at the Georgia Institute of Technology and Director of the Emory Center for MR Research, Emory University School of Medicine, Atlanta, Georgia. He is known internationally for his pioneering work at Emory University involving four-dimensional imaging of the cardiovascular system using magnetic resonance (MRI). His current research focuses on integrated imaging and predictive biomechanical modeling of coronary atherosclerotic disease.
Cedric Yu, DSc, FAAPM
Edward Jackson, PhD, FAAPM, FACR
University of Maryland School of Medicine Translating NIH funding to a [potential] clinical device in breast cancer radiation therapy
University of Wisconsin Translating NIH / NIBIB funding to clinical reality in quantitative diagnostic imaging
INTRODUCTION: John Boone, PhD, FAAPM, FACR, AAPM President, UC Davis Medical Center
www.aapm.org/meetings/2015AM
AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
AAPM PRESIDENT’S REPORT John M. Boone, Sacramento, CA
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e come to Anaheim in July as a group of scientists with a common interest in medical physics, but most likely with very different jobs on a day-to-day basis. Over the years, AAPM in general, and the good folks who organize the Annual Meeting, have developed a meeting program that has something for everyone; clinical physicists, educators, regulatory physicists, corporate scientists, and researchers alike. I’m excited about the meeting program that has been organized for 2015, and I’m sure that members and nonmembers alike will find the niche in the meeting that is most compatible with their needs and job function. I come from an era in our field such that I have been involved in (diagnostic) clinical work, loads of teaching, as well as research. Thus, the appeal of the Annual Meeting is multifaceted for me; and I hope for you as well. As I came into AAPM leadership, I felt that it was important to continue to add value to membership. Individual AAPM membership includes a subscription to the journal Medical Physics, and this subscription was the primary reason why I joined the society over 30 years ago. Since then, we have added another journal to our portfolio, the Journal of Applied Clinical Medical Physics (JACMP)*. In the interest of adding more value to AAPM membership, over the past 6 months we have negotiated with the leaders of the National Commission on Radiation Protection (NCRP) and the International Commission on Radiological Units and Measurement (ICRU). I’m proud to say that these negotiations have led to contracts, and now the majority of NCRP and ICRU reports are available at no cost to AAPM members — downloadable from the AAPM website (see colored link boxes, lower left on the homepage). We are developing another program to add value to AAPM membership: the AAPM Certificate Program. At the Anaheim meeting (on Wednesday), a daylong session on MR-guided Radiation Therapy (MRgRT) is being given. With an additional fee, attendees can register in the Certificate Program; after completing the full course and successfully passing an online test, a (very nice) AAPM Certificate of completion will be mailed to registrants. This is the inaugural course, and other Certificate courses are being planned for future AAPM-sponsored meetings. Finally, there is another, most important AAPM member benefit for those members and members-tobe who come to AAPM meetings such as the Annual Meeting in Anaheim. This most valuable benefit, however, requires effort — sometimes considerable effort — on the part of the member. This special AAPM benefit is only redeemed by volunteering in the scientific, educational, or professional activities of the society. To get involved, sit in on new Task Group (TG) meetings, committee, subcommittee, town hall or editorial board meetings that are held face-to-face. The vast majority of these meetings are open to the AAPM general membership. These meetings are posted on the AAPM Anaheim meeting website. Listed there are hundreds of opportunities to get involved in the operations of the society. Participating in task group activities was how I got involved in AAPM three decades ago. Showing up to TG or committee meetings does not confer membership in that committee — but by speaking up and engaging the existing group — by demonstrating interest, passion, and/or expertise in the topic at hand — many times this catches the eye of the chair and leads to an invitation to formally participate.
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
President, cont. AAPM values all its members — it’s who we are. But AAPM as an association moves the field of Medical Physics forward with the considerable help of over a thousand AAPM volunteers (out of 8000 members). If you happen to be cynical about this offer (there are a few of you out there) and are thinking “that Boone guy is just trying to trick us into working for free,” I would say that this is no trick — the old saw is true — the more you give, the more you get back. Participating in AAPM has been one of the most valuable and rewarding aspects of my career — indeed, of my life — I have put a lot of time in, and spent thousands of unpaid hours contributing to AAPM activities. But in return, scores of my scientific colleagues have become lifelong personal friends. I have canoed the Amazon rainforest, trekked the Arctic tundra, sailed the Straits of Georgia, and discussed radiation hormesis in my hot tub with friends who I have met through AAPM. And professionally speaking, have you ever thought of where accolades such as professional expert, scientific guru, master teacher, top of the field, thought leader, etc. actually come from? Largely, they come from your Medical Physics colleagues in AAPM that know you. So, volunteering leverages your membership, and is a rewarding way to bolster your professional reputation while making some excellent friends in the process. See you in Anaheim! *While published under AAPM auspices, and certainly a jewel in our crown, the JACMP is an open access journal and therefore is not technically a membership benefit.
MRI is Coming to Rad Onc. ARE YOU READY?
MRgRT Certificate of Completion Course • Wednesday, July 15 • 7:30am – 6:00pm This Certificate Program, launching at the AAPM 2015 Annual Meeting, will provide documented advanced training in subspecialty areas of medical physics. The focus of the 2015 Certificate Program is MRI-guided Radiation Therapy.
For an additional fee, AAPM member attendees are eligible to receive the certificate of completion for the course based on attendance and comprehensive online examination. Upon passing the exam, registrants will receive a framed certificate issued by AAPM to demonstrate successful completion of the training program.
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If MRI isn’t already in your practice, it soon will be. We encourage medical physicists in any stage of his or her career to take advantage of the Certificate Program, solidify knowledge, hone skills, and demonstrate training and expertise on this vital emerging topic via the Certificate of Completion. AAPM member attendees may register for the Certificate Program on-site. John M. Boone, AAPM President James Balter, 2015 Certificate Program Coordinator
AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
EXECUTIVE DIRECTOR’S COLUMN Angela Keyser, College Park, MD AAPM Adds Value to Your Membership with ICRU Partnership AAPM has entered into an organizational subscription agreement with the International Commission on Radiation Units and Measurements (ICRU) to provide access to ICRU publications at no cost to AAPM members. You may now access the ICRU reports from the AAPM website (after login).
AAPM Professional Information Survey The 2014 Professional Survey is available online. You can download a PDF from the web or have the document emailed to you. If you have any problems, please contact HQ.
New AAPM Publications The “Parallel Imaging in MRI: Technology, Applications, and Quality Control – The Report of AAPM Task Group 118” is now available on the AAPM Reports list. On May 17th, two new Medical Physics Practice Guidelines (MPPG) were published in the Journal of Applied Clinical Medical Physics (JACMP); Volume 16, Number 3 (2015): • AAPM Medical Physics Practice Guideline 3.a: Levels of supervision for medical physicists in clinical
training • Medical Physics Practice Guideline 4.a: Development, implementation, use and maintenance of
safety checklists
New AAPM Member Profile Features We now allow you to break out your Specialization by percentage instead of choosing a primary and secondary Specialty. We have also, by popular demand, added the ability to display fellowships other than AAPM and ACMP in your directory listing. Choose Fellowships from the profile menu to add any of the AAPM recognized fellowships listed there. While not a new feature, we are highlighting the member profile Funding screen. Enter your valid era Person ID and become eligible to win an Apple watch ($400 cash-equivalent gift card). Going to #AAPM2015 in Anaheim? Download the AAPM Annual Meeting App for your device here.
AAPM Meetings More Information AAPM 57th Annual Meeting & Exhibition More Information
SRT/SBRT: Safe and Accurate Delivery of Hypofractionated Radiation Therapy Register Here The AAPM Expanding Horizons Travel Grant Apply Here
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IMPORTANT LINKS
AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
Executive Director, cont.
Meeting News Going to #AAPM2015 in Anaheim? Download the AAPM Annual Meeting App for your device here. Remember – dedicated time to Visit the Vendors on Wednesday, July 15 from 9:30 AM – 11:00 AM. No sessions are scheduled to conflict during this time so make sure to visit the Exhibit Hall. An online Buyers Guide is available, with information about the exhibiting companies. Exhibit hours are: Sunday, July 12 – 12:30 – 5:30 PM Monday, July 13 – 9:00 AM – 5:00 PM Tuesday, July 14 – 9:00 AM – 5:00 PM Wednesday, July 15 – 9:00 AM – 2:00 PM Make plans to attend the 2015 Annual Business and Town Hall Meeting on Wednesday, July 15 from 6:15 PM – 7:30 PM in Room 213 of the Anaheim Convention Center. Members of the AAPM Board of Directors want to hear directly from the membership. What should AAPM be working on? How can the organization better serve you? Here’s your chance to be heard. AAPM’s President and Treasurer will report on the status of the organization. Selected speakers have been asked to provide handouts for their presentations to be posted on the website. Please check the Handout site for the progress on submissions. AAPM plans to digitally capture the following session types at the 57th Annual Meeting for posting in the AAPM Virtual Library. The digital capture list will be available at the Member Services Counter: • Continuing Education Courses • Symposia • Proffered sessions are not included in the AAPM Virtual Library.
Posted presentations include streaming audio of speakers and presentation slides. Selected presentations given during the 57th AAPM Annual Meeting & Exhibition will be available on USB Flash Drive following the meeting. The USB Flash Drives are PC & Mac compatible only. Orders will be shipped 6 weeks following the meeting. Order Your USB Flash Drive. Register Now – SRT/SBRT: Safe and Accurate Delivery of Hypofractionated Radiation Therapy September 18-20, 2015 in Detroit, Michigan
This comprehensive course is aimed specifically for clinical physicists and will address the many aspects of SRT/SBRT in a single format. This program has applied for approval of 8.50 SAMs credits. Registrants will receive a hardcover copy of Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy.
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
Executive Director, cont. Dates to Remember August 6 – Deadline to receive early registration fees August 24 – Last day to make Hotel Reservations at the group rate RSNA 2015 RSNA celebrated the 100th anniversary of its founding in 1915 and RSNA 2015 will mark the 101st Scientific Assembly and Annual Meeting. Reminder: AAPM’s Headquarters Hotel is the Hyatt Regency Chicago located at 151 E. Wacker Drive.
AAPM Expanding Horizons Travel Grant Deadline Extended to September 1st! Up to twenty $1,000 travel grants per year will be awarded for the purpose of providing additional support for student and trainee travel to conferences that are not specifically geared toward medical physics. Learn more & apply AAPM Expanding Horizons Travel Grant
Grants and Fellowship Recipients Congratulations to the following AAPM funding recipients: AAPM/RSNA Fellowship for the training of a doctoral candidate in the field of Medical Physics Awarded for the first two years of graduate study leading to a doctoral degree in Medical Physics. The recipient is: Dylan Breitkreutz The American Association of Physicists in Medicine (AAPM) Diversity Recruitment through Education and Mentoring Program “DREAM” (formally MUSE) Designed to increase the number of underrepresented groups in medical physics by creating new opportunities, outreach and mentoring geared towards diversity recruitment of undergraduate students in the field of medical physics. Students participating in the program are placed into summer positions that are consistent with their interest. Students are selected for the program on a competitive basis to be a DREAM fellow. Each DREAM fellow receives a stipend from AAPM. The DREAM Fellows for 2015 are: Vernita Adkins, Catherine Carranza, Howard Heaton, Brigid McDonald, Mayisha Nakib, Adam Pruneda, Jose Trevino and Davon Webb Summer Undergraduate Fellowships Designed to provide opportunities for undergraduate university students to gain experience in medical physics by performing research in a medical physics laboratory or assisting with clinical service at a clinical facility. In this program, AAPM serves as a clearinghouse to match exceptional students with exceptional medical physicists, many who are faculty at leading research centers. Students participating in the 10-week program are placed into summer positions that are consistent with their interest. Students are selected for the program on a competitive basis to be an AAPM summer fellow. Each summer fellow receives a stipend from AAPM. The Summer Undergraduate Fellows for 2015 are:
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
Executive Director, cont. Andrew Joseph Boria, Kimberley Ann Lam Tin Cheung, Megan Emily Dagys, Fatimah Eashour, Nicholas Alexander Gabriel, Caryn Geady, Andrew Michael Headley, Rebecca Lynn Meerschaert, Austin Matthew Patrick, Marie Schwalbe, Trevor Lewis Vent and Jonathon Luke Yuly Research Seed Funding Initiative These grants are awarded to provide funds to develop exciting investigator-initiated concepts, which will hopefully lead to successful longer term project funding from the NIH or equivalent funding sources. It is expected that subsequent research results will be submitted for presentation at future AAPM meetings. The recipients for 2015 are: Stephen Yip, PhD, Dana-Farber Cancer Institute Ke Li, PhD, University of Wisconsin-Madison John G. Eley, PhD, University of Maryland School of Medicine
Headquarters News
Congratulations to Shayna Wise on her June 22 marriage to Stuart Knazik. I’m sure you will join me in wishing Mr. and Mrs. Knazik many years of wedded bliss! And, if that wasn’t enough excitement for Shayna, the big day was right on the heels of her recent promotion to a newly created position of AAPM Programs Manager. In her new role, Shayna Knazik’s main focus will be supporting the AAPM Science Council. I firmly believe that part of the success of AAPM HQ operations is our ability to attract and retain an excellent team of high performing association management professionals. The following AAPM team members celebrated an AAPM anniversary in the first half of 2015. I want to publicly thank them and acknowledge their efforts. Nancy Vazquez
19 years of service
Onasis Budisantoso 7 years of service
Jennifer Hudson
14 years of service
Viv Dennis
5 years of service
Zailu Gao
14 years of service
Melissa Liverpool
4 years of service
Karen MacFarland
12 years of service
Rachel Smiroldo
4 years of service
Lynne Fairobent
11 years of service
Shayna (Wise) Knazik 1 year of service
Lisa Schober
10 years of service
Robert McKoy
Laurie Allen
8 years of service
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1 year of service
AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
FROM THE EDITOR’S DESK Mahadevappa Mahesh, Baltimore, MD
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elcome to the pre-Annual Meeting issue of the AAPM Newsletter. This year the 57th Annual Meeting & Exhibition in Anaheim, CA takes place earlier than in previous years and I hope readers find this issue particularly helpful as it contains highlights of the various programs being offered. In addition, most of the regular columns are related to the upcoming Annual Meeting and include information about the various sessions that have been organized. I would also like to draw your attention specifically to the President’s column, where he passionately advocates the role the volunteers play in the organization and highlights the returns each of us get by doing so. This issue also contains articles from the ABR Physics Trustees discussing the MOC and course requirements, AAPM committee reports including the TG-51 Working Group Update, Insurance Subcommittee Report, History Committee Report and a report from the International Affairs Subcommittee regarding the Used Equipment Donation Program (UEDP). For those who are participating in the ACR MRI Accreditation Program, I ask you to peruse Penny Butler’s column regarding the changes in the 2015 ACR MRI QC manual that was recently published. Readers may also find the Research Spotlight article on the emerging role of high-intensity focused ultrasound (HIFU) particularly interesting. I would like to, once again, applaud the AAPM leadership for facilitating free online access to the majority of the ICRU reports. As many of us constantly refer/cite ICRU reports, I consider this a great membership benefit, as these reports are quite expensive to purchase. I will close my column by wishing all of you a happy summer and I look forward to seeing many of you at the Annual Meeting in Anaheim, California.
NEW MEMBER BENEFIT... Online ICRU Publications Now Free to AAPM Members! AAPM has entered into an organizational subscription agreement with the International Commission on Radiation Units and Measurements (ICRU) to provide access to ICRU publications to AAPM members at no cost to the member. You may now access the ICRU publications from the AAPM website (after login).
www.aapm.org/pubs/ICRU/
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
EDUCATION COUNCIL REPORT George Starkschall, Houston, TX
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f it’s June, we are getting ready for the AAPM Annual Meeting in Anaheim, and I must be writing about the presentations at the upcoming meeting that are of interest to all medical physicists interested in education. This year the Education Council Symposium will address an issue that appears to be on the minds of many medical physicists, whether or not they are involved in medical physics education. That issue is the accreditation and certification of medical physics educational programs and individual medical physicists. Accreditation and certification, although similar, address two different populations. How accreditation and certification standards are developed and how educational programs and individuals are assessed based on these standards is the topic of the Symposium.
The stated objectives of the Symposium are (1) to recognize the difference between accreditation of an educational program and certification of an individual, (2) to identify the two organizations primarily responsible for these tasks, (3) to describe the development of educational standards, and (4) to describe the process by which examination questions are developed. I will be chairing this Symposium, which will include speakers from both CAMPEP and the ABR, including Wayne Beckham, Brenda Clark, Chet Reft, Tony Seibert, and Jerry Allison. The Symposium will be held on Sunday, July 12, from 11:00 am to 12:30 pm in Room 213 of the Convention Center, and I hope you will be able to attend. Several other activities that address education will be held at the Meeting. On Sunday morning from 9:30 to 11:00 am, in Room 210 of the Convention Center, the Students and Trainees Subcommittee of the Education and Training of Medical Physicists Committee will be holding its annual Student Meeting. The topic of their meeting is “Medical Billing and Regulations: Everything You Always Wanted To Know, But Were Too Afraid to Ask.” Also Sunday, from 3 to 6 pm, a general poster session will be held in the Exhibit Hall featuring posters addressing education. This poster session will be an opportunity for meeting attendees to meet with poster exhibitors to discuss the content of their posters. On Monday, from 1:45 to 3:45 pm, in Ballroom A, the annual Innovation in Medical Physics Education session will present six proffered presentations on innovative methodologies for medical physics education. The outstanding presentation will be recognized with a cash prize. This year’s AAPM meeting appears to be somewhat lighter on educational topics than meetings of previous years. Members are encouraged to remedy this by proposing symposia or refresher courses on education for next year’s meeting. See you in Anaheim.
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
PROFESSIONAL COUNCIL REPORT Douglas E. Pfeiffer, Boulder, CO
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write this while attending the International Society for Computed Tomography 17th Annual International Symposium on MultidetectorRow CT. This excellent program is information-dense and is informative, even for a small town physicist, which is the point of this article. Yes, this article is diagnostically focused; I promise to address therapy issues in the next article. I have learned a large number of things while attending this program. I hope to be able to bring some of this information back to my own hospital and clients, and be able to communicate some of it well enough that it will make sense. But some of what I’ve learned is subtler than that. The speaker panel is comprised mostly of radiologists, all of who are from large academic institutions. While they are knowledgeable about physics and have good physics support, they still have questions and depend heavily on their physicists. Not just for research information, but for daily support. Because, fantastic radiologists as they are, their expertise is different from ours. Our knowledge and experience complements theirs. But the main thing that I’ve learned is that I don’t know enough imaging. As clinical physicists, we are called upon by The Joint Commission and the American College of Radiology, if not by facilities yet, to assist in the development and optimization of imaging protocols. Yet, how many of us in the field know what the clinical demands of a particular indication are? How do trauma exams differ from outpatient exams? What does oncology imaging require? If we don’t know these things, how can we help to develop protocols appropriate for them? Radiology is shifting from volume based to value based, and clinical medical physics must shift with it. If we allow clinical medical physics to remain an invisible service, we will be viewed as over-paid technicians and we will lose. Instead, we must demonstrate that we bring value to the clinic beyond testing tubes and meeting regulatory requirements. We must demonstrate that we also know imaging and can work with radiologists and technologists to optimize the use of all imaging equipment, because the Imaging Department itself may soon be shifting from an income center to a cost center.
This will require a fundamental shift in how we provide medical physics support, both in house and as consultants. Even our private outpatient imaging centers will feel the push, and reimbursements will not be as they have been. If we are largely invisible, talking only to perhaps the director or the technologist, testing the equipment in the minimum time possible, covering only regulatory compliance, we will soon be gone. These facilities will feel the pressure to add value, not just accomplish volume, and the clinical qualified medical physicist can and should be central to that added value. As I have said before, medical physics, especially clinical medical physics, must undergo a transition. We must move from being focused on equipment and measurements to being focused on the patient and the facility. The challenge will come in helping them to understand what we have to offer. But if we don’t know imaging, if we can’t speak their language, we will fail.
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
Professional Council, cont. This doesn’t impact only clinical physicists. Researchers, too, must be aware of what clinical demands are. Some interesting areas of research and development have been brought up in this very clinically oriented meeting. Clearly, our industry colleagues have a huge role to play in this environment and many new potential areas of medical physics support have been addressed, from quantitative image analysis to oncologic imaging to big data analysis. All of these are ripe for bright, young medical physicists to grab hold of and run with. The first challenge will be for us to really learn imaging. We must start attending clinical radiology meetings, learning what radiologists, oncologists, and surgeons need. Tumor boards, if you provide services to hospitals, are a great place to start. If you don’t serve hospitals, take some time to talk to the radiologist, learn how the imaging is working for him, and find out what she needs to see in the images. And give the radiologists an opportunity to see that you are more than a glorified, expensive technician. As medical physicists, we have much to offer medicine. As a profession, we need to start seeking out those areas that we can positively impact. As individuals, we need to start learning the language of our colleagues, and working with them to add value to medicine.
REGISTER NOW!
Early Registration Deadline: August 6
SRS/SBRT has progressed from a specialty procedure only per-
formed at major academic centers to a widely accepted treatment regimen adopted by a majority of Radiation Oncology Clinics. The technology has undergone major developments from frame-based to frameless implementations as a result of the advances of high-precision IGRT tools. Delivery devices have also technically diversified, ranging from dedicated machines such as the Gamma Knife all the way to all-purpose linacs to protons. Respiratory motion management techniques have allowed treatments to expand into lung and GI; radiobiological arguments increasingly support hypofractionation for GU applications.
www.aapm.org/meetings/2015SBRT/
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SRS/SBRT treatment techniques tie together technological advancements of the last decade into a high-precision, hypofractionated course of treatment while minimizing treatment uncertainties. Most physicists have gained SRS/SBRT skills and knowledge through attending educational offerings at AAPM, ASTRO and RSS; this comprehensive course is aimed specifically for clinical physicists and will address the many aspects of SRS/SBRT in a single format.
AMERICAN ASSOCIATION of PHYSICISTS IN MEDICINE
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
SCIENCE COUNCIL REPORT Jeffrey H. Siewerdsen, Baltimore, MD Go West! AAPM Science – and a Glimpse of the Future – in Anaheim
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ne of the main vehicles for AAPM Science is our Annual Meeting, so it is a pleasure to remark on the numerous ways that the AAPM scientific mission is reflected in this year’s meeting – and on some of the challenges that lie ahead. This year will be my last as Chair of the Scientific Program, and I am thrilled to see such a tremendous program in Anaheim – the same city where I was introduced to AAPM 21 years ago at the 1994 Annual Meeting. I remember being overwhelmed. There is no scientific meeting that better captures the connection of imaging and therapy than ours, and there is none that provides a better platform and audience for technology in translation from research to first clinical use. In the last two decades, our meeting has provided the spotlight and primary forum for many of the breakthroughs that now define the state of the art in medical imaging and radiation therapy: flat-panel x-ray detectors, digital mammography, tomosynthesis, CAD, statistical image reconstruction, and molecular imaging… the emergence of image-guided radiotherapy using cone-beam CT, PET/CT, and MRI… Monte Carlo methods, deformable image registration, IMRT optimization, and probing the physical / biological basis of treatment response. Today’s research is tomorrow’s clinical tool, and the scientific program of our Annual Meeting provides a powerful crystal ball on what the future holds. In Anaheim 1994 – my first AAPM meeting – the total number of proffered submissions was just shy of 600 abstracts; in Anaheim 2015, it is over 2000. Such impressive growth (3.4x) in scientific content outpaces even the steady growth in other areas of our thriving Association over the same time period, including: 1.20x growth in exhibitor participation, 1.86x growth in general attendance, and 2.10x growth in general membership. I hope students and early-career scientists coming to Anaheim feel the same overwhelming sense of awe and inspiration that I felt 21 years ago, and that they recognize our Annual Meeting as the premier forum for medical physics research. The strength of the 2015 Scientific Program comes first and foremost from the proffered Abstracts. This year saw a ~15% increase in submissions, with more than 2000 abstracts submitted, each reviewed by at least 5 blinded reviewers to earn a spot among the ~440 oral or ~220 SNAP oral presentations. In addition, the meeting includes more than 20 invited symposia on cutting-edge topics in imaging and radiotherapy. Organizing such a large, excellent program is the charge of the Scientific Program Subcommittee, and several specific kudos are in order for the lineup in 2015. First are the Therapy, Joint, and Imaging Track Directors and Co-Directors, Eric Ford, Ross Berbeco, Tinsu Pan, and Srinivasan Vedantham, who shouldered the lion’s share of work on the sessions and symposia. This year’s meeting also includes a special Ultrasound Track directed by Chris Diederich and Mark Holland, with sessions
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
Science Council, cont. on diagnostic imaging, image guidance, and high-intensity focused ultrasound (HIFU). (See also this issue’s RESEARCH SPOTLIGHT article on the emerging technology of HIFU.) As always, Laurie Allen and Lisa Rose Sullivan provided indispensable expertise and support to the Scientific Program Subcommittee, managing every aspect of the program you see in Anaheim. Finally, and with great appreciation, credit goes to Kristy Brock, who joined as this year’s Co-Chair and will see the scientific program forward as Chair in years ahead. It has been a pleasure working with Kristy on the program, and I am deeply indebted to her expertise, creativity, and commanding perspective of the field. Kristy also spearheaded countless new initiatives, including major improvements in abstract reviews, the Electronic Poster Campus, the Virtual Press Room, and countless items — big and small — to bring the scientific program into being. What’s New? Details of What’s New at the Annual Meeting can be found here — including a special MR-Guided Radiation Therapy mini-track and certificate course, the special Ultrasound Track, the new Electronic Poster Campus, and the inaugural Carson-Zagzebski Distinguished Lectureship on Medical Ultrasound, featuring an invited presentation by Dr. Michael Tanter, from the Langevin Institute in Paris, on ultra-high-speed ultrasound imaging. From the Science Council perspective, a few other items deserve special note: Our Future – Young Investigators If you’ve read this column over the last 6 months, then you know that first among Science Council priorities is a thriving future for the science of medical physics, and the most valuable resource in that mission is our young / early career scientists. No surprise, then, that the Annual Meeting includes numerous new initiatives aimed to better engage and enrich the experience of early career physicists. Three cases in point: Continuing this year, the Young Investigators Symposium has been moved to Monday morning — a fantastic kickoff for the week that removed many schedule conflicts from Sunday afternoon Task Group meetings. Moreover, the Scientific Program runs the symposium UNOPPOSED by other scientific sessions — a position otherwise enjoyed only by the President’s Symposium — so that all our attention can be on the Young Investigators. With such schedule obstacles removed, please plan to attend the Young Investigators Symposium — Monday July 13 at 7:30 am in Ballroom A. Secondly, watch for the “Featured Presentation” talks in scientific sessions. These are proffered abstracts judged by the reviewers and Track Directors to be especially outstanding in scientific quality. In particular, abstracts submitted by winners of each year’s Research Seed Funding Awards are given special consideration for a Featured Presentation, earning an extended 20-minute time slot in which to report the results of their research supported by AAPM.
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
Science Council, cont. Thirdly, this year’s meeting welcomes the inaugural class of SCAMPs! (Science Council Associates Mentorship Program). Eight SCAMP awardees were selected from 57 applications, earning an opportunity to shadow AAPM leadership throughout the year on Task Groups and other volunteer activities, the Awards Ceremony and Night Out, and navigating / networking in the vibrant scientific community of medical physicists. The Science Council Symposium Each year, the Science Council identifies a topic at the cutting edge of medical physics research and solicits proffered abstracts for the Science Council Session. This year’s topic is Radiomics and Imaging Genomics, featuring 12 abstracts on this emerging area of scientific research, including one Best-in-Physics presentation. The talks cover an impressive depth and breadth in Radiomics research, including: image feature / texture analysis, correlation to genomic profiles and treatment outcome, and application in all tomographic imaging modalities. Reinvigorating Science There could be no stronger endorsement of the importance of the AAPM scientific mission than in the theme set forth by our President in the 2015 Annual Meeting — to Reinvigorate Scientific Excellence in our field. This call to action is not just to medical physicists whose primary work is research: scientific excellence can and should resound in every aspect of a medical physicist’s work. We are scientists — one and all — and we carry the privilege and responsibility of such distinction, especially in light of the fantastically advanced state of the art in diagnostic imaging and radiation medicine. Whether day to day in assuring the safe, effective use of technology in the clinic or in cutting-edge research that aims to create the clinical tools of tomorrow, a scientific perspective and approach to our work is essential. It is also critical to our recognition and value among peers in healthcare. No matter what area of medical physics you work in – imaging or therapy, clinical or research – I hope the President’s theme resonates with your calling as a physical scientist: to understand the fundamentals, find problems, hypothesize a solution, question the norm, bring new understanding, and create positive change. Defining the Future The surest way to predict the future is to build it yourself. As scientists with a pivotal role in healthcare, the future takes shape by our hands. Our daily work in the clinic, the classroom, the laboratory, and at large continually strengthens the foundation and pushes the boundaries of our field — from understanding the physical basis of disease to creating the technologies that will become tomorrow’s clinical tools. And that work reaches crescendo each year at the Annual Meeting. I’m looking forward to seeing you in Anaheim — for a glimpse of the future.
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
ABR NEWS Jerry D. Allison, Geoffrey S. Ibbott and J. Anthony Seibert ABR Medical Physics Trustees The ABR has made a number of changes to its policies and procedures that may be of interest to medical physicists, as well as medical physics residents, students, and program directors. Maintenance of Certification (MOC) Improvements The ABR has made a number of improvements to its MOC process. The ABR is adding the category of Participatory Quality Improvement as an additional way to meet the MOC Part 4 requirement. Participatory QI is based on active participation in quality and safety activities in your medical physics practice. Examples of Participatory Quality Improvement activities are: • Participation as a member of an institutional/departmental clinical quality and/or safety review
committee • Participation as a member of a root cause analysis team evaluating a sentinel or other quality or
safety-related event • Creation or active management of, or participation in, one of the elements of a quality or safety
program These are just a small sample of Participatory Quality Improvement activities. A full list will appear soon on the ABR website. In addition, the ABR is working to simplify its attestation requirements for Part 1 (Professionalism), Part 2 (Lifelong Learning and Self-assessment), and Part 4 (Practice Quality Improvement). 10-Year Rule The ABR has instituted a 10-year rule that requires a candidate to become board eligible no more than 10 years after passing the Part 1 exam. The main reason for this rule is because some candidates pass Part 1 but never continue with the certification process. The 10-year rule will allow dormant files to be closed. This rule has already been implemented, but candidates who are reaching their 10-year limit will have until 2017 to become board eligible. ABR Initial Certification Audits The ABR audits a small percentage of Part 1 applications to ensure certification requirements are being met. Past audits have shown that the vast majority of Part 1 candidates meet ABR certification requirements. We have made a number of changes in the way we evaluate candidates who are audited. These changes have been driven by our desire to more closely align our requirements with CAMPEP expectations for graduate programs and residencies.
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
ABR News, cont. Bioscience and Medical Physics Course Requirements Bioscience Courses
Beginning in 2016, the two required bioscience courses will be: • Anatomy and Physiology • Radiobiology
Beginning in 2016, ABR will require the following medical physics courses: • Radiological Physics and Dosimetry • Radiation Protection and Safety • Fundamentals of Medical Imaging • Radiation Therapy Physics
Credits for these bioscience and medical physics courses must total at least 18 hours. Variation in the naming of courses is acceptable, as long as they match those required by CAMPEP. Applications The number of Part 1 applications for 2015 remained about the same as in 2014, returning to historic values. We suspect that the large increases in 2012 and 2013 were due to an influx of candidates who wished to enter the system before CAMPEP requirements were fully implemented. The number of candidates entering the system is closely related to the number of candidates certified each year.
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eRA Commons ID
If you have a NIH Commons account, then you have an eRA Person ID. Here’s how to find yours... INSTRUCTIONS: 1. Go to: https://public.era.nih.gov/commons/public/login.do and enter your username and password, then press Login 2. Click Personal Profile — or just go to: https://public.era.nih.gov/commons/ppf/selectProfile.do?method=init&menu_itemPath=603 3. Look for the large yellow box with your name in it. The number at the bottom is your Person ID 4. Go to http://www.aapm.org/memb/profile/funding.asp?show=funding to enter that Person ID and answer a few questions
1
Enter Your Valid eRA Person ID and Become Eligible to Win an Apple Watch! ($400 cash-equivalent gift card)
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
LEGISLATIVE & REGULATORY AFFAIRS REPORT Lynne Fairobent, College Park, MD Update on Licensure in Texas Last year we learned that there was a possibility that licensure of medical physicists in Texas would end. During the 2014 AAPM Annual Meeting in Austin, considerable effort was expended to educate legislators and their staff of the importance of medical physicists and licensure. During the 2015 Texas legislative session - SB 202 was passed transferring the licensing of medical physicist from the Texas Medical Physics Licensure Board to the Texas Board of Medicine as an advisory committee. While some may feel this is a step backward, licensure has been maintained. Discussions have been initiated between the medical physicists in Texas and the Texas Board of Medicine to ensure the continuation of licensure. The effective date for Texas Board of Medicine to absorb the medical physics licensees is September 1, 2015. For those currently licensed in Texas, my understanding is that everyone will have to be fingerprinted and have a background check, and all the existing licensees will be transferred as is to the Texas Board of Medicine.
Image Gently® Update The Alliance for Radiation Safety in Pediatric Imaging was formed in 2008 with four sponsoring organizations: Society for Pediatric Radiology, American Association of Physicists in Medicine (AAPM), American Society of Radiological Technologists (ASRT), and American College of Radiology (ACR). Under the effective leadership of Marilyn Goske, MD, a pediatric radiologist at Cincinnati Children’s Hospital and Medical Center, the Alliance has welcomed approximately 100 other member professional societies and organizations which represent more than one million health care workers who come in contact with pediatric patients. Dr. Goske will receive the award of AAPM Honorary Membership in Anaheim at the 2015 Annual Meeting in recognition of her achievements. The mission of the Alliance is to improve the safety and effectiveness of imaging of children from straightforward dental x-rays to complex computed tomography or interventional angiography examinations. The Image Gently® Campaign launched by the Alliance strives to increase awareness, education, and advocacy on the justification of the examination and the radiation dose to children. When Dr. Goske retires as chairperson of Image Gently® on July 1, 2015, Donald Frush, MD, FACR will become the new chairperson. Keith Strauss, MSc, FAAPM, FACR will become the vicechairperson and will assist with the leadership of the Alliance. Keith is currently a member of the AAPM’s Board of Directors. The success of the Image Gently® Campaign has not gone unnoticed. Image Wisely® was created in 2010 by the Radiological Society of North America, ACR, AAPM and ASRT to better address adult imaging safety and effectiveness in this country. EuroSafe was formed on the continent of Europe in 2015. During this year, AfroSafe has been initiated in Africa.
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
Legislative & Regulatory Affairs, cont.
Congratulations to Dr. Bennett Greenspan
AAPM member Bennett Greenspan, MD, MS has been elected Vice President-Elect of the Society of Nuclear Medicine and Molecular Imaging (SNMMI). Dr. Greenspan is currently a Professor in Radiology at the Medical College of Georgia / Georgia Regents University in Augusta, Georgia. He has 31 years of experience in clinical Radiology and Nuclear Medicine, and the teaching of Radiology and Nuclear Medicine to residents in Radiology and Nuclear Medicine and to medical students and nuclear medicine technology students. In addition, he has had further training in radiation safety, health physics, and medical physics, and has an MS degree from UCLA in medical physics. Dr. Greenspan is certified by the American Board of Radiology in Diagnostic Radiology and Nuclear Radiology, and by the American Board of Nuclear Medicine in Nuclear Medicine. Dr. Greenspan has been an active member of AAPM since 2006 and serves on the Nuclear Medicine Subcommittee, the Imaging Physics Curricula Subcommittee and Medical Physics Education of Physicians Committee. He served on the GEPRC of CAMPEP for 23 years, from 1991 through 2013. He is also a member of the Southeast Chapter of AAPM. Dr. Greenspan’s presidential year at SNMMI will be 2017 - 2018. I look forward to continued interaction with Dr. Greenspan and the opportunity it brings to further AAPM and SNMMI relationships.
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SCIENTIFIC PROGRAM • The Science Council Session – Radiomics / Imaging Genomics. THERAPY TRACK • In Memoriam of Warren Sinclair: Physics Applications for New Radiobiology • New Methods to Ensure Target Coverage • The Science of QA • Clinical Trials in Proton and Particle Therapy (SAM) • Modeling Cancer Complexity • New Developments in Knowledge-Based Treatment Planning and Automation • NIH-Funded Research: Instrumental in the Pursuit of Clinical Trials and Technological Innovations • Current Topics in SRS/SBRT (SAM) IMAGING TRACK • The Joint AAPM-WMIS Symposium: Linking PreClinical and Clinical Trials: Co-Clinical Trials • Advances in Cone-Beam CT and Emerging Applications • Technological Advances in PET/MR Imaging • Iterative Reconstruction in CT • CT Lung Cancer Screening and the Medical Physicist: Moving Forward (SAM) • Emerging Applications of X-Ray Imaging • Advances in Breast Imaging JOINT IMAGING/THERAPY TRACK • The Joint ESTRO-AAPM Symposium: Imaging Markers for Assessment of Treatment Response • MRgRT Mini-Track: New Developments in Hybrid MR-treatment: Technology (SAM) • MRgRT Mini-Track: New Developments in Hybrid MR-treatment: Applications (SAM) • Real-Time Imaging and Tracking Techniques for Intrafractional Motion Management (SAM)
• Bridging the Scales from Molecules and Cells to Clinical Applications • Radiomics: Advances in the Use of Quantitative Imaging used for Predictive Modeling • Nanotechnology for Imaging and Therapy • Computational Phantoms ULTRASOUND (SPECIAL 3 DAY PROGRAM) Diagnostic Ultrasound, Ultrasound Therapy and Image Guided Interventions • Diagnostic Ultrasound Imaging Quality Control and High Intensity Focused Ultrasound Therapy Hands-on Workshop • Ultrasound Guidance for RT Interventions • Ultrasound Guided Systems for Brachytherapy • HIFU Therapies: A Primer • MR-guided Focused Ultrasound Therapy in Oncology • Advanced Novel Technologies & Delivery Strategies • Therapeutic Strategies and Image Guidance • Treatment Planning Strategies, Modeling, Control • Educational: Diagnostic Ultrasound QA • Carson/Zagzebski Distinguished Lecture – Mickael Tanter, PhD “The Advent of Ultrafast Imaging in Biomedical Ultrasound” • Advances in Ultrasound Contrast Agents for Diagnosis &Therapy • Advances in Ultrasound Imaging Technology • Advances in Breast Ultrasound Imaging PROGRAM SPONSORS • Philips Healthcare – Ultrasound • Siemens Medical Solutions • The Focused Ultrasound Foundation
www.aapm.org/meetings/2015AM
EDUCATIONAL PROGRAM • Point/Counterpoint: Biological Dose Optimization • MRgRT Mini-Track: MRI for Radiation Oncology (SAM) • Implementing SBRT Protocols (SAM) • Knowledge-Based Treatment Planning Automation (SAM) • Education Council Symposium: Accreditation • Outcomes of Hypofractionated Treatments – and Certification: Establishing Educational Results of the WGSBRT (SAM) Standards and Evaluating Candidates Based • Small Field Dosimetry: Overview of AAPM TG-155 on these Standards. and the IAEA-AAPM Code of Practice (SAM) • Proton Therapy (SAM) THERAPY TRACK • Spine SBRT (SAM) • Current Trends in Y90-Microsphere Therapy: • Optimization of CT Planning Imaging and Delivery and Dosimetry Techniques to Reduce Radiation Dose Resulting • Electronic Charting in EBRT and Brachytherapy from Daily Imaging Guidance Procedures (SAM) • Clinical Applications of 3D Printing • Real Time Imaging Verification and Tracking for • Optimizing the Treatment Planning Process Moving Targets • Electronic Brachytherapy (SAM) • Reference Dosimetry for Beam Modalities Other • Pediatric Radiation Therapy Planning, Treatment, Than MV Photons (SAM) and Late Effects (SAM) • Task Group 158: Measurement and Calculation • Breast Brachytherapy: The Phoenix of Radiation of Doses Outside the Treatment Volume from Therapy (SAM) External-Beam Radiation Therapy Treatment • Patient Specific Q/A: Pre-treatment, During- treatment, and Post-treatment (SAM) IMAGING TRACK • The Global Cancer Challenge: What Can We • ACR Update in MR, CT, Nuclear Medicine, and Do? (SAM) Mammography • Imaging, Treatment Planning, and QA for • A Review of Radiologic Anatomy (SAM) Stereotactic Body Radiation Therapy (SBRT) • Pediatric Imaging (SAM) (SAM) • CT Scanner Hardware and Image Quality • Task Group 100 (SAM) Assessment (SAM) • The Aftermath of TG-142 (SAM) • Digital Tomosynthesis (SAM) • Incident Learning/RO-ILS (SAM) • MR Basics I (SAM) • Deformable Image Registration: Is it Right for • MRgRT Mini-Track: MR Basics II (SAM) Your Clinic (SAM) • CT Lung Cancer Screening Part 1 (SAM) • MRI-Based Motion Management for RT (SAM) • Mobile Viewing Devices (SAM) • Stereotactic Radiosurgery (SAM) • MR Safety (SAM) • In Memoriam of Jacques Ovadia – • Nuclear Medicine 101 (SAM) Reinvigorating Scientific Excellence: Electron • Nuclear Medicine 102 (SAM) Beam Therapy – Past, Present and Future More than 50 hours of educational courses in medical imaging and radiation therapy physics will be offered. This will include SAMS courses for diagnostic, medical nuclear, and radiation therapy physicists.
www.aapm.org/meetings/2015AM
EDUCATIONAL PROGRAM (cont.) PRACTICAL MEDICAL PHYSICS • Radiation Safety Officer Update • High-Impact Presentations • Clinical Implementation of HDR Brachytherapy (SAM) • Use of End-of-Life Brachytherapy Devices • Eye Lens Dosimetry for Patients and Staff (SAM) • Radiochromic Film Dosimetry Update (SAM) • Imaging Equipment Specification and Selection in Radiation Oncology Departments
• Treatment Planning System Commissioning and QA (SAM) • Practical Statistics for Medical Physicists (SAM) • Practical Guidelines for Commissioning Advanced Brachytherapy Dose Calculation Algorithms (SAM) • Software Libraries for your Research Projects – Don’t Start From Scratch • Clinical Networks: IT for Radiation Oncology
PROFESSIONAL PROGRAM • Professional Council Symposium: Alternative Career Opportunities for Medical Physicists • Economics Update • Session in Memory of Penny S. Slattery: Medical Physics Workshop – Update: Journal Improvement Activities and Guidance on Writing and Reviewing Papers • AAPM Professional Liability Insurance Update • Journal of Applied Clinical Medical Physics: Mission and Submission • Workforce Assessment Committee Update • Academic-Industrial Research and Development Partnerships – Nuts and Bolts, Pitfalls and Rewards • PQI • MBAs for Medical Physicists: Business School Basics
• MBAs for Medical Physicists: DABR-MBA Alumni Panel • Administrative Aspects of Medical Physics • Management Skills for Medical Physicists • The International Electrotechnical Commission (IEC): What is it and Why Should Medical Physicists Care? (SAM) • New Member Symposium • Developments in International Medical Physics Collaborations in Africa and Latin America • Preparing for the ABR Diagnostic and Nuclear Medicine Physics Exams • Building, Maintaining and Improving Physics Residency Programs • It Can’t Happen to Me! My Position Has Been Terminated, Now What?
www.aapm.org/meetings/2015AM
PARTNERS IN SOLUTIONS Partners in Solutions returns again this year with vendors providing physics-level presentations on topics selected by AAPM in a special-purpose lecture room built on the exhibit floor. These sessions provide practical information for the clinical physicist from the people who know the systems in depth! CE credit is available. This year’s topics are: • Imaging: Tools for Collecting and Analyzing Patient Radiation Dose Index Information • Therapy: Deformable Image Registration, Contour Propagation, and Dose Mapping
Thank you for your service! On behalf of the AAPM, I would like to thank Jeff Siewerdsen for his dedication and service to the Annual Meeting as the Scientific Program Chair for the past 5 years, and his service to the Scientific Program in various roles over the past 10 years. Jeff has spearheaded many innovative initiatives, including increasing the media presence of the AAPM Annual Meeting, implementing the ‘Dawn to Dusk’ program, creation of the annual Specialty Track, establishing collaborative symposia with other societies, development of the Campus Posters and this year’s Electronic Campus, the Best-in-Physics and Featured Presentation designations, and bringing FUN to the annual meeting with offerings like the Physics Pheud. From these and innumerable ‘behind the scenes’ efforts to improve scientific quality, efficiency of meeting planning, and coordination with Education and Professional Programs, our Annual Meeting has grown stronger each year. I am grateful to have had the opportunity to learn from Jeff while serving as Co-Chair for the past year and as a Track Director in the past. His energy and excitement for science is an inspiration to all who have had the chance to work with him. You leave huge shoes to fill, Jeff! Thank you for your service to AAPM. The Annual Meeting and all of its attendees have greatly benefited from your dedication to advancing science. —Kristy Brock, Scientific Program Co-Chair
AAPM 2015 DATES TO REMEMBER JULY 12–16
57th Annual Meeting & Exhibition
AUGUST 20 11:59 PM ET
Deadline to complete the online evaluation in order to receive CAMPEP Credit (equivalent to CME category 1), SAMs Credit (equivalent to SA-CME), MDCB and RLI Credits
AUGUST 27
Credits released for meeting attendees
www.aapm.org/meetings/2015AM
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
ACR ACCREDITATION: FAQs FOR MEDICAL PHYSICISTS Priscilla F. Butler, M.S., Senior Director and Medical Physicist, ACR Quality and Safety Does your facility need help on applying for accreditation? In each issue of this newsletter, I’ll present frequently asked questions (FAQs) of particular importance for medical physicists. You may also check out the ACR’s accreditation website portal for more FAQs, accreditation applications and QC forms. The following questions are for the ACR Magnetic Resonance Imaging (MRI) and Breast MRI Accreditation Programs. Please feel free to contact us if you have questions about MRI or breast MRI accreditation.
Q. The long-awaited 2015 ACR Magnetic Resonance Imaging Quality Control Manual has been released. (Visit the ACR Catalog Section.) What has changed since the 2004 version? A. In addition to the many revisions incorporated to improve the clarity of the manual, several tests and criteria are different from those in the 2004 Manual. They are outlined below: • Interslice RF interference tests – removed • RF cross-talk assessment – removed (all modern systems were found to be capable of easily
meeting the previous guideline of maintaining at least 80% SNR when comparing 0-gap images to 100% slice-gap images; however, the manual emphasizes that it is the responsibility of the qualified medical physicist/MRI scientist to determine if this assumption is appropriate for each specific system being evaluated and to add a cross-talk assessment if warranted)
• Magnetic field homogeneity assessment – alternative approaches provided to assist the
qualified medical physicist/MRI scientist when evaluating systems that do not allow access to phase-angle images
• Radiofrequency coil check: percent image uniformity (PIU) - previously implemented criteria
added (PIU ≥87.5% for systems ≤1.5T and PIU ≥82% for 3T systems)
• Radiofrequency coil check: percent signal ghosting (PSG) – new criteria added (PSG <2.5%) • Low-contrast detectability (LCD) - new criteria added (at least nine spokes of test objects for
≤1.5T systems and at least 37 spokes of test objects for 3T systems)
• MRI safety program assessment – new test and checklist • Separate large and small phantom weekly technologist QC forms
Q. When do current MRI- or breast MRI-accredited facilities or new facilities applying for MRI or breast MRI accreditation have to comply with the test criteria in the new 2015 ACR MRI Quality Control Manual? A. Effective approximately one year from the publication (July 1, 2015) of the 2015 ACR MRI Quality Control Manual, all ACR MRI- or breast-MRI accredited facilities and those applying for accreditation must maintain a documented quality control (QC) program and must comply with the minimum frequencies of testing outlined in the manual. This date is July 1, 2016.
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THE AAPM EXPANDING HORIZONS
Travel Grant
TYPE: Grant OPEN: 5/1/15 DEADLINE: 9/1/15 NOTIFICATION: 10/1/15 APPLICATION MATERIALS TO BE SUBMITTED • Personal statement describing long term career goals, motivation to attend the selected meeting, and expected scientific value of attendance on the applicant’s dissertation project or future research (2 pages maximum). •
Curriculum Vitae.
•
Letter of recommendation from the applicant’s supervisor or department head confirming that additional travel expenses will be covered.
•
Budget indicating expected expenses.
THE AAPM EXPANDING HORIZONS TRAVEL GRANT will award up to twenty $1,000 travel grants per year for the purpose of providing additional support for student and trainee travel to conferences that are not specifically geared toward medical physics. There will be two calls for applications per year to accommodate the variable timeframes of different scientific meetings. The travel grant program is designed to provide an opportunity to broaden the scope of scientific meetings attended in order to introduce students and trainees to new topics which may be of relevance to medical physics research and which may subsequently be incorporated into future research in order to progress the field in new directions. ELIGIBILITY CRITERIA • Must be a member of AAPM in good standing at the time of application •
Must be a current graduate student, post-doctoral candidate, or resident
•
Proposed meeting must not be specifically-related to medical physics
•
Examples of ineligible conferences include: • AAPM Annual Meeting • AAPM Spring Clinical Meeting • AAPM Chapter Meetings • American Society for Radiation Oncology (ASTRO) Annual Meeting • Radiological Society of North America (RSNA) Annual Meeting • Any meeting that the applicant’s group is regularly attending, this will be judged on a case-by-case basis.
•
Examples of eligible conferences include: • American Physical Society (APS) Annual Meeting • Biophysics Society (BPS) Annual Meeting • Physical Sciences in Oncology Centers (PSOC) Annual Meeting • Radiation Research Society (RRS) Annual Meeting • World Molecular Imaging Conference (WMIC)
APPLICATION PROCESS • Please combine documents in a single PDF, and send to Research Committe c/o Shayna Knazik, exhg@aapm.org.
American Association of Physicists in Medicine | www.aapm.org
AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
INTERNATIONAL AFFAIRS SUBCOMMITTEE REPORT Mohammed K. Zaidi, Houston, TX Donation Of Used Equipment
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he objective of the Used Equipment Donation Program (UEDP) of the American Association of Physicists in Medicine (AAPM) and the International Organization for Medical Physics (IOMP) is to help developing countries acquire used equipment in good working condition. The staff verifies, the best that they are able, that it meets the need of the recipient country. Some of the countries that have benefited from this program were: Argentina, Bangladesh, Brazil, Egypt, India, Iran, Nigeria, Pakistan, Philippines and United Arab Emirates (UAE) and the donors were from Australia, Germany, Lebanon, United Kingdom and the United States of America. The program is a modest one and under review to ensure it meets current needs, regulations and guidance. Links, liaison and co-operation with EDPs of WHO, AAPM, ASTRO, IFMBE, ISSRT, ICCE, and PAHO are made to run a smooth program. I look forward making connections with these international organizations during the World Congress 2015.
We have received a large donation of 30 pieces of equipment used in calibration of radiographic and therapeutic machines and also a donation of a used CT and a mammographic machine by Ms. Anita Galkin-Dwork, daughter of the late Benjamin M Galken (who was a member of AAPM all his life), offered by the Estate in Philadelphia, have been obtained. I plan to ship these items to Dr. Kalu, Amazing Grace Clinic, Umuahia, Abia State, Nigeria, shipping port Apapa Lagos, Nigeria. The necessary shipping arrangements are currently being made. Examples of other requests that we have received are a request for a Block-cutter from the Ghana Society of Medical Physics, Oncology Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana and another request from CEO WHO International Aid (forwarded by Dr. KY Cheung) from Liver Trust Foundation, Faisalabad, Pakistan for UE to help them screen and diagnose. The UE’s are desperately needed so please contact us if you have one that could be donated. The program strives to only accept usable equipment that is less than 10 years old. Some of the items recently donated and which we are currently looking for a home for are: water tanks, hydraulic lift assembly, dual channel electrometer — this system is controlled by Wellhofer’s OmniPro Accept software. TLD reader, farmer ionization chambers and stack of ready pack x-ray films, USG Doppler, Video-EEG equipment and CT machine. The equipment donated to our Program is in good working condition but we don’t guarantee its usefulness. The donations of used equipment are sometimes tax deductible. AAPM/IOMP will not be responsible for any warehousing expenses or loss if the used equipment donated cannot be shipped. If you would like to donate, or want specific used equipment donated to your organization, please contact the UEDP Manager, Mohammed K. Zaidi, or Dr. Yakov Pipman.
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In a pinch? NEW
SURVEY SENSOR
Introducing the new Survey sensor for RaySafe X2 Sometimes less is more. That’s why we’ve created a versatile sensor that simplifies the operation of leakage and scatter measurements in diagnostic X-ray applications. Let us introduce the new Survey sensor for RaySafe X2 which is the latest addition to the ever expanding X2 sensor range. The versatile X2 Survey sensor is primarily used to perform leakage and scatter measurements in diagnostic X-ray applications. The intuitive user interface displays dose, dose rate, mean energy and time, as well as the dose rate waveform.
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OFFER For a limited time only, we’re including the new Survey sensor with a purchase of the RaySafe X2 Prestige kit (R/F, MAM, CT, and Light sensors already included) so don’t wait and get yours now.* * Promotion offer is only valid on purchase(s) made between March 1, 2015 and October 31, 2015. May not use this promotion in conjunction with contract or special pricing. Not valid on prior orders or purchases; cannot be transferred or otherwise redeemed for alternative products, services or credits.
AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
AAPM HISTORY COMMITTEE REPORT Lawrence N. Rothenberg, Chair, New York, NY AAPM History Symposium in Anaheim — Radiological Physics Pioneers
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he 2015 AAPM History Symposium entitled “Radiological Physics Pioneers: Roentgen and the AAPM Award Eponyms – William Coolidge, Edith Quimby, and Marvin Williams – Who were they and what did they do?” is scheduled as Session WE-G-213-0 and occurs on Wednesday, July 15, 2015 from 4:30-6:00 PM in Room 213 of the Anaheim Convention Center. The speakers are Perry Sprawls on Roentgen and Larry Rothenberg on Coolidge, Quimby, and Williams. We hope that you plan to attend. Information on previous AAPM History Symposia including “Evolution of Radiation Treatment Planning” (Austin 2014), “Early Developments in Teletherapy” (Indianapolis 2013), “Historical Aspects of Cross-Sectional Imaging” (Charlotte 2012), “Historical Aspects of Brachytherapy” (Vancouver 2011), “50 Years of Women in Medical Physics” (Houston 2008), and “Roentgen’s Early Investigations” (Minneapolis 2007) can be found in the Education Section of the AAPM Website.
Watch AAPM Historical Video Interviews Online Almost all of the AAPM video interviews of Physicists (and a few Physicians) of Note are now available online. These include not only the contemporary series of interviews recorded at Annual Meetings by an outside vendor from 2005 – 2014, and conducted by Michael Gossman, Robert Gould, Azam Niroomand-Rad, Rene Smith and Larry Rothenberg, but also more than 120 interviews conducted mainly by Robert Gorson from 1990 through 2004. Several additional interviews will be conducted this year in Anaheim. AAPM will be forever indebted to Professor Gorson for his great dedication in conducting the interviews, and providing his own video equipment to record them. These earlier interviews can now be viewed online due to Gorson’s incredible initiative in converting all of his original video files to Flash Video (.flv) format. These Flash files have been made available on our website due to the further efforts of Michael Woodward and Farhana Khan at AAPM Headquarters as well as Chris Marshall, our previous Website Editor. To access these interviews, visit the AAPM website, choose “AAPM” on the left side of the main page, then “History & Heritage,” then finally the “Historical Interviews” tab.
View the AAPM Chapter History Posters in Anaheim We are pleased to announce that once again newly updated Chapter history posters will be presented in a central area of the Convention Center for viewing in Anaheim. The Chapter History Poster project has been supervised by Co-Chair Michael Gossman and coordinated by Lisa Schober of the AAPM HQ Staff. At least 17 AAPM Chapters will be participating. Of course, we are also greatly indebted to the many AAPM Chapter members who have made contributions to their Chapter History posters. The History committee was successful in gaining approval by AAPM to have a poster session on Chapter history indefinitely as a part of each Annual Meeting.
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NEW MEMBER SYMPOSIUM Tuesday, July 14 • 4:30pm – 6:00pm • Room 304, Anaheim Convention Center
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s a new member of AAPM, it is easy to feel overwhelmed by the size and complexity of the association and to be unaware of the benefits and opportunities available to members. At this year’s AAPM Annual Meeting in Anaheim, we will host a New Member Symposium where you can learn more about the organization, member resources, opportunities to get involved, and about topics of particular interest to new professionals. We encourage you to take advantage of this great opportunity to learn valuable information and to grow your professional network. Following an introduction from Dr. John Boone, AAPM President, Justin Keener, Chair of the New Professional Subcommittee, will speak on, “Physics of the AAPM.” Next will be Dr. George Sherouse sharing invaluable information in his talk, “Things You Won’t Be Able to Say Somebody Should’ve Told You.”
Get Your Picture Taken. There will be a photographer there to take pictures for your profile in the AAPM directory.
Registered attendees will receive a raffle ticket. Enter to win a complimentary registration for the 2016 Annual Meeting in Washington, DC!! In addition, all new members who register for the Symposium will receive a drink ticket, good for one complimentary soda or beer served after the New Member Symposium during the social with committee chairs from four AAPM Councils: Science, Education, Professional and Administrative.
www.aapm.org/meetings/2015AM/
AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
TG-51 WORKING GROUP UPDATE Yimei Huang, Detroit, MI On Behalf of the TG-51 Working Group A Review of the ADCL Proficiency Tests The AAPM TG-51 protocol for clinical reference dosimetry starts with an ionization chamber calibration factor that is directly traceable to national standards for absorbed dose to water, maintained by Primary Standard Laboratories. TG-51 recommends that clinical physicists obtain calibration for their ion chamber every other year by an Accredited Dosimetry Calibration Laboratory (ADCL), which serves as a secondary standard for disseminating the primary standard to the clinic. Thus, the operation of the ADCLs directly impacts clinical reference dosimetry across North America. The operations of the ADCLs are supervised by the AAPM Calibration Laboratory Accreditation (CLA) Subcommittee, which accredits, supervises and maintains the highest level of confidence in the quality of the ADCL system. Currently there are three ADCLs in the U.S, and in alphabetical order, they are K&S Associates (Nashville, TN), MD Anderson Cancer Center (Houston, TX), and University of Wisconsin-Madison (Madison, WI). One criterion for maintaining ADCL accreditation is participating and passing NIST-sponsored proficiency tests covering the scope of calibration service offered by the laboratory. The proficiency test evaluates calibration performance by means of a NIST measurement quality assurance (MQA) test wherein the same dosimetry system, such as an ionization chamber or brachytherapy sources, is evaluated at both NIST and an individual ADCL for difference in calibration coefficient. In particular, the required ADCL performance on the proficiency test for reference class instrument is 0.5% in Co-60. Recently, historical proficiency test data from the three ADCLs were collected, a subset of which has been anonymized and is presented in Figure 1. Figure 1 (left) presents results from proficiency tests for air kerma calibration coefficients, , performed over the past 15 years from the three labs. Figure 1 (right) shows similar results for absorbed dose calibration coefficients, The data in both figures represent the deviation of calibration coefficients as determined by the ADCL relative to those determined by NIST. Two of the ADCLs exhibit systematic deviations in the proficiency data for but are both within tolerance nevertheless. The mean percent difference of the proficiency data for is (0.10±0.06)% (one standard deviation) from Lab 1 and (-0.15±0.12)% from Lab 3. Averaged over the three ADCLs, the agreement with NIST is (0.01±0.15)% for It is worth pointing out that the first measurement of performed for the proficiency test by Lab 2 was different from the NIST measurement by -0.47%. The lab subsequently repeated the measurements of both and three times, each with improved agreement. The average difference compared to NIST for measured at the three labs is (-0.04±0.18)%. This independent review of the ADCL proficiency tests demonstrates that each lab is within the 0.5% criterion required by the accreditation for the NIST MQA test in Co-60 radiation, and is consistent in maintaining its secondary standard over the 15 year time period. Clinical physicists can be assured that chamber calibrations are equivalent regardless of the ADCL selected. We appreciate the high
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TG-51, cont. quality secondary calibrations maintained by each ADCL and their great service to AAPM members and their institutions in the diagnosis and treatment of patients.
Figure 1. Anonymized proficiency test results for years.
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(left) and
(right) from the three ADCLs tracked over the past 15
AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
EMERGING ROLE FOR HIFU COMES INTO FOCUS Highlights From Today’s Cutting Edge Medical Physics Research
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Research Spotlight
n the 23 years since high-intensity focused ultrasound (HIFU) was first wed to MRI1 as a way to guide the placement of focused high-intensity ultrasound beams and provide real-time feedback on thermal targeting, the technology has shown increasing potential for surgery, oncology, and neurology at-large. With the many avenues at our disposal, HIFU offers the potential to dominate much of the therapeutic physics landscape in the coming decades, particularly as a reliable alternative to ionizing radiation therapy and minimally invasive surgery. Specifically, MRI-guided HIFU (MRgHIFU) has seen early success2 locating and destroying a variety of diseases, including cancer, through thermal ablation or locally delivering drugs and biologics. MRgHIFU is also a field rich with research opportunities in medical physics.
Thanks to soft tissue contrast resolution and thermal mapping capabilities that are superior and more accurate with MR than ultrasound imaging, MRI facilitates treatment planning, visualization of the target, control of energy deposition, and immediate imaging evaluation of treatment response. Current commercial state-of-the-art clinical MRgHIFU systems include ExAblate by Insightec Inc.3 and Sonalleve by Philips,4 deployed on 1.5T or 3.0T MRI platforms. Early clinical applications involve ablation of uterine fibroids, painful bone metastasis, and treatment of essential tremor.5 The first two applications have received FDA approval by InSightec, and various clinical trials are underway for other indications or MRgHIFU systems. “Uterine fibroids marked the clinical entry point of MRgHIFU applications,” explains Keyvan Farahani (National Cancer Institute). “Unlike traditional oncological therapies, HIFU avoids ionizing radiation and appears to pose no threat of adverse effects from cumulative dose.” The outpatient procedure lasts up to a few hours, depending on the tumor size, and patients typically resume normal activities within a day or two. “For those reasons,” Farahani says, “the scope of potential HIFU applications extend to prostate cancer ablation, liver cancer ablation, vessel occlusion, and disruption of the blood-brain barrier for image-guided drug delivery to the brain for a variety of neurologic and neurooncologic indications. Before Kullervo Hynynen and Ferenc Jolesz brought HIFU and MRI together, HIFU was severely hamstrung by its inability to offer visual cues on targeting and region of therapeutic effect. “With MRgHIFU drug delivery, one can deliver thermosensitive carriers, such as liposomes, that can burst at a certain temperature and locally release their therapeutic payload,” Farahani said. Compared to traditional chemotherapy, which takes a more blanket approach, MRgHIFU allows local delivery of high doses of therapy while minimizing systemic uptake. MRI also allows the clinician to immediately view, either directly or with an imaging contrast agent, the extent to which a complicating mass of tissue has been treated.
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
Research Spotlight, cont.
HIFU thermal ablation of a uterine fibroid monitored by MR imaging and thermometry. Coronal (a) and sagittal (b) views of the heating target with temperature map overlays. [Courtesy of Philips Healthcare]
Now, the technology is branching out to conquer diseases that have confounded medical science for decades, such as Alzheimer’s disease. Earlier this year, Australian scientists6 reported on their study of scanning ultrasound treatments to clear away beta-amyloid plaques in mouse models over six to eight weeks, improving their cognitive function in several domains, including memory and reasoning skills. The research built upon Hynynen’s earlier work, published last year, that showed MRgHIFU treatments to the hippocampus increased neural plasticity and curbed amyloid protein abnormalities.7 And nearly a decade prior, the pioneering duo were locally delivering Herceptin through a disrupted BBB in mice in the pursuit of resolving disorders of the central nervous system.8 Clearly, the technology leaves much to be gained on the back end. “Opportunities for medical physics in HIFU include development of robust quality assurance methods, treatment planning, dosimetry, and treatment monitoring,” explains Farahani, “in addition to training of other scientists and clinicians in proper use of the technology, regulatory, commissioning, and certification roles.” A recent Research Spotlight article featured MRI as a growing modality in radiation therapy. In fact, there are strong analogies between MRgHIFU and MRgRT as both approaches use external beams of energy and MRI to guide treatments. “The growth of MRgRT will further fuel interest in MRgHIFU as an adjunct or alternative mode of therapy,” Farahani predicts. “There is a long and rich scientific culture associated with radiation therapy that in many ways can provide a model for MRgHIFU, although the requirements for MRgHIFU may be different and at times less demanding since therapeutic effects are readily visualized and measured by MRI.” To better address the interest of medical physicists in MRgHIFU, AAPM has implemented Task Group 241, whose primary responsibilities include indentifying relevant methodologies, phantoms, and software for performance assessment and clinical applications of MRgHIFU. Technical assessments cover the nuts and bolts of MRgHIFU, the quantitative metrics behind the technology, and pinpointing quality assurance measures and procedures. As with any piece of technology that hopes to disrupt the current landscape, there are economic and competitive challenges that slow progress. To that end, Farahani sees the AAPM as a key player for technical assessment, translation to new clinical applications, and development of QA protocols for this emerging technology that has much to offer to the future of medicine and medical physics.
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Research Spotlight, cont. 1. Cline HE, Schenck JF, Hynynen K, Watkins RD, Souza SP, Jolesz FA. MR-guided focused ultrasound surgery. J Comput Assist Tomogr. 1992 Nov-Dec;16(6):956 2. Jolesz FA, Hynynen K, McDannold N, Temapny C. MR imaging-controlled ultrasound ablation: a non-invasive image-guided surgery. Magn Reson Imaging Clin N Am. 2005 Aug; 13(3):45-60. 3. www.insightec.com/ExAblate-Operation-Room-Future.html 4. www.healthcare.philips.com/main/products/mri/systems/sonalleve/ 5. Elias WJ, Huss D, Voss T, et. al. A pilot study of focused ultrasound thalamotomy for essential tremor. N Engl J Med. 2013;369(7):640-8. 6. Leinenga G, Götz J. Scanning ultrasound removes amyloid-β and restores memory in an Alzheimer’s disease mouse model. Sci. Transl. Med. 2015; 7, 278ra33. 7. Burgess A, Dubey S, Yeung S, et al. Alzheimer Disease in a Mouse Model: MR Imaging–guided Focused Ultrasound Targeted to the Hippocampus Opens the Blood-Brain Barrier and Improves Pathologic Abnormalities and Behavior. Radiology. 2014 Dec 273(3). 8. Kinoshita M, McDannold N, Jolesz FA, Hynynen K. Noninvasive localized delivery of Herceptin to the mouse brain by MRI-guided focused ultrasound-induced blood-brain barrier disruption. Proc Natl Acad Sci U S A. 2006 Aug 1;103(31):11719-23. Epub 2006 Jul 25.
Measure Your Success with a Shiny New AAPM Ruler!
Stop by the Career Services area at AAPM 2015 in Anaheim to pick yours up.
Visit the Career Services wall to post copies of your resume and browse the latest job openings, or add open positions at your institution for meeting attendees to consider.
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focus on our future The AAPM Education & Research Fund supports the development of our great profession via the provision of seed money for research, Summer Undergraduate Fellowships, DREAM Program Fellowships, fellowships for PhD students and support for clinical residencies. Without contributions from our generous members we would never have been able to provide the now over 100 grants, fellowships and residencies since the inception of the Fund 20 years ago. All contributions are tax deductible. Larger donations may be designated for specific fellowships, residencies, travel awards, research or other suitable purposes.
GIVE TO THE AAPM EDUCATION & RESEARCH FUND DONATE NOW!
AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
INSURANCE SUBCOMMITTEE (INSUSC) REPORT Anas Orfali, Harbor Springs, MI, Gregory J Courlas, Lynnwood, WA and David W Jordan, Cleveland, OH Professional vs. Commercial General Liability Insurance A common question we receive at the Insurance Subcommittee (INSUSC) relates to the difference between Professional Liability Insurance (PLI), and Commercial General Liability Insurance (GLI). A number of medical physics consultants are finding that they are being asked to provide GLI coverage when they contract with hospitals and are confused when their PLI policy is not accepted for this requirement. This article is intended to help clarify the difference. The term “insurance” has many definitions and various meanings. The online Merriam-Webster dictionary defines insurance as coverage by contract whereby one party undertakes to indemnify or guarantee another, against loss or peril. So insurance is essentially a tool used to mitigate a specific risk. It is prudent to be clearly aware of the definition of the covered parties under the insurance contract, what specifically is covered, and what are the exclusions and conditions of the insurance policy. Knowledge of the basic elements of the insurance contract can help identify the specific risks that are covered, and more importantly the coverage “gap” that may still remain. PLI and GLI belong to a family of insurance products called Liability Insurance, or “third party” insurance. Liability Insurance indemnifies the insured against legal liability arising out of bodily or personal injury to a third party or for damage to the third party’s property. A common example of liability insurance products is automobile insurance policies. Professional Liability Insurance: PLI is generally designed to provide coverage to the insured, who is typically an individual in a professional occupation such as Medical Physics. The PLI would pay on behalf of the insured Medical Physicist for damage claims made against him or her, or their professional business. The damage claim can arise on account of Bodily Injury, Property Damage, or Personal Injury, as a result of the insured rendering or failing to render services, or making negligent mistakes in performing services which result in injury, in their professional occupation. The professional occupation, in our case Medical Physics, is usually specified as part of the policy declaration and the damage claims are most frequently related to patient injury. PLI, much like any other insurance policy, will have specific conditions, definitions, and exclusions. For example, PLI usually excludes fraudulent or criminal acts, practicing a profession other than specified in the declaration, or any obligation under workers’ compensation, unemployment compensation or disability benefits law. Also PLI is not a substitute to automobile insurance nor employers’ liability insurance.
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Insurance Subcommittee, cont. General Liability Insurance: Physicists who are self-employed and have their own business should consider General Liability Insurance (GLI), also commonly termed Commercial General Liability Insurance. This insurance protects the physicist’s business from all sorts of liability risks. Indeed, many hospital and organizations that the physicist may do business with will require that the physicist name the contracted organization on the General Liability Insurance plan. Each GLI policy can have different specifics on coverage; however, broadly, three areas of liability are covered by GLI. These include: Property Damage, Bodily Injury during the course of business, and Personal and Advertising Injury (to the client or the client’s employees). General Liability Insurance policies are designed to shield the physicist’s business from the expense of litigation and judgments awarded against the business, as well as out of court settlements. This includes the attorney fees and any investigative expenses and medical expenses in case of injury from accidents on your premises or from accidents caused by you on the clients premise. This liability insurance can also cover damages from copyright violation. On the other hand, GLI does not cover the physicist from all risks associated with his/her business. Risks that are not covered include Professional Liability. It’s important to know that GLI does not cover the physicist or business in the case of professional mistakes and damages occurring from the services offered or solutions recommended in the course of the physicist’s work. Separate PLI is needed to protect the business and cover the litigation fees, damages, and punitive costs in these cases. Auto related accidents in the course of business usually are not covered, though they may be added by endorsement. Unprotected risks include injury to the physicist or his/her employees while on the job. Example: In many businesses and professions, including medical physics, it can be difficult to sort out exactly which type of liability (and which type of liability insurance coverage) would apply to a given situation, especially those involving bodily injury. The most common scenarios used as examples of general liability would be common accidents, such as slip-and-fall type accidents, occurring on the insured’s premises. It may be helpful to think of general liability as liability for risks that could be caused or incurred by anyone providing services to or in a hospital or clinic. Medical physics professional liability insurance would cover situations stemming directly from the practice of medical physics, such as bodily injury sustained by a patient as a result of an error in measurement, calibration, or treatment planning made by the physicist. A day in the life of one improbably unfortunate medical physicist, Dr. “Ken McCormick” (not his real name), illustrates the range of liability issues that such a character could encounter. Dr. McCormick is a private practice medical physicist who provides services under contract to a local hospital. On his way in to the hospital, Dr. McCormick hits a pedestrian in the parking lot with his car, injuring her. The costs of her medical treatment would be covered by Dr. McCormick’s automobile insurance policy
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Insurance Subcommittee, cont. since he was operating a motor vehicle when he caused the harm. He proceeds to the department, where one of his tasks is to straighten and organize some of the equipment. As he is moving equipment, he fails to notice a leaking phantom that leaves a wet and slippery trail on the hallway floor. A passing nurse slips on the wet spot and is injured. While an employee injured on the job would normally be covered by workers’ compensation insurance, in this instance it is likely that the workers’ compensation insurer would in turn pursue a claim against Dr. McCormick for his negligence in creating this hazard. This would fall under Dr. McCormick’s general liability policy. Finally, distraught by the day’s events, Dr. McCormick makes a crucial error in performing a linac output calibration that evening. The following day, several patients are injured by radiation overdoses delivered before the error is detected. These patients sue Dr. McCormick, and his medical physics professional liability policy is invoked to cover the costs. While these examples are extreme and contrived, they raise some interesting issues about the gaps and overlaps in different types of liability insurance. For example, while Dr. McCormick was on his way to his medical physics job when the parking lot accident occurred, his use of the vehicle would not normally be considered commercial use that would be excluded from the liability clause of an ordinary passenger vehicle insurance policy. Had he been operating a company-owned vehicle rather than his personal car, that may well have been the case, his personal auto policy likely would not have covered this claim. Finally, general liability coverage extends beyond bodily injury, although that is the type of claim most often considered. An important additional aspect is protection from claims such as defamation and false advertising. Suppose Dr. McCormick made a false public statement about his client hospital, particularly one that caused a competitor hospital to lose business. Dr. McCormick’s client would likely be sued by its competitor, and in turn the client would turn to Dr. McCormick. Dr. McCormick’s general liability policy would be used to provide coverage for damages resulting from defamation or false advertising claims. Insurance companies use different forms (contracts), which may have additional enhancements, limits or exclusions of coverage. A standard recommendation is to always have any insurance program reviewed with the appropriate insurance professionals, who can include licensed insurance agents, brokers, and attorneys. Members of the INSUSC continue to strive to address questions brought to the subcommittee’s attention, and the membership is encouraged to direct further questions to any of the subcommittee’s members. We would also like to invite all those interested to attend the upcoming professional symposium on AAPM Professional Liability Insurance to be held on Monday, July 13, 2015 in Room 213 during the upcoming AAPM 57th Annual Meeting & Exhibition in Anaheim, CA.
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AAPM Newsletter • Volume 40 No. 4 JULY | AUGUST 2015
AAPM HQ TEAM... AT YOUR SERVICE! Angela Keyser, College Park, MD
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long with the AAPM Annual Meeting, Summer School, and Spring Clinical Meeting, AAPM also sponsors specialty meetings throughout the year. As we’ve seen the availability of the volunteer hour shrink, the HQ team now manages most non-technical, programrelated tasks previously handled by volunteers. While all the members of the AAPM HQ team play an important role in the meetings and programs processes, the Meetings and Programs Department handle many of the major responsibilities. Lisa Rose Sullivan will celebrate her 23rd Anniversary as a member of the AAPM team later this year. She joined the staff in November 1993 as Projects Coordinator and was one of the original five Maryland staff members hired when the AAPM HQ offices relocated from NYC to College Park, Maryland. Lisa was promoted to Exhibits and Scientific Program Manager in 1998 and then to the management team as Director, Meetings and Programs in 2005. Lisa oversees the meetings and programs operations and manages the 6 meetings team members. She also serves as the staff liaison to the Education Council. Nancy Vazquez joined the HQ team as the 6th staff person in 1996, serving as the Receptionist. She was promoted to Programs Manager in 1998 and took on the responsibility of managing the registration processes for the various AAPM-managed meetings. In 2007, the production of the AAPM Newsletter was brought in house, with Nancy working directly with Editor Mahesh to produce the bi-monthly publication. Nancy is also the staff liaison to the Awards and Honors Committee. She manages the Awards and Honors nomination process and plans the yearly Awards and Honors Ceremony and Reception. Earlier this year, Nancy took on the program management for AAPM’s report process. Karen MacFarland, Senior Meetings and Programs Manager, joined the team in 2003. Karen handles the meeting negotiations and logistics for many of the association meetings scheduled throughout the year, including the Annual Meeting and the Summer School. In 2007, she passed the Convention Council Industry exam to become a Certified Meeting Planner. Corbi Foster joined AAPM in 2007 as Meetings and Programs Manager. She handles the meeting negotiations and logistics for the Spring Clinical Meeting. Corbi is also responsible for the arrangements for AAPM committee meetings at the Annual Meeting and during RSNA and ASTRO. Along with Karen, Corbi shares the responsibility for overseeing specialty meetings and various retreats and “stand alone” committee meetings held throughout the year.
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At Your Service, cont. Laurie Allen joined the team in 2007 as the Customer Service Representative. Later that same year, she was promoted to the newly created position of Programs Assistant, overseeing the meeting program development and abstract submission processes for the Annual Meeting, Spring Clinical Meeting and specialty meetings. In 2014, Laurie was promoted to Programs Manager in recognition of her increased level of responsibility in the overall meeting program management process. When Laurie was promoted in 2007, Jackie Ogburn was hired to fill our Customer Service Representative position. In 2008, Jackie was promoted to the newly created position of Education Assistant and in 2011 was promoted to the position of Education Manager. Jackie oversees the operational aspects of the Associationâ&#x20AC;&#x2122;s educational activities, including the Online Learning, SAM and Virtual Library programs. She also manages the AAPM grants and funding opportunities and provides staff support to CAMPEP. Rachel Smiroldo started as a summer intern with AAPM in 2010. Upon her graduation from college in 2011, she joined our staff as the Exhibits and Meetings Assistant. Rachel coordinates the exhibit programs for both the Annual and Spring Clinical meetings and assists with the registration processes for all meetings.
AAPM Meetings and Programs Department Team Back Row (left to right): Corbi Foster, Lisa Rose Sullivan, Nancy Vazquez Front Row (left to right): Rachel Smiroldo, Jackie Ogburn, Laurie Allen, Karen MacFarland
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UPCOMING AAPM MEETINGS: July 12–16, 2015 AAPM 57th Annual Meeting & Exhibition Anaheim, CA September 18–20, 2015 SRT/SBRT: Safe and Accurate Delivery of Hypofractionated Radiation Therapy Detroit, MI March 5–8, 2016 AAPM Spring Clinical Meeting Salt Lake City, UT June 12–16, 2016 AAPM Summer School Medical Physics Leadership Academy Chantilly, VA
AAPM | One Physics Ellipse | College Park, MD 20740 | 301-209-3350 | www.aapm.org